Upper extremity braces

ABSTRACT

A brace for restricting the movement of a shoulder joint, the brace including a trunk module attachable to a human body, wherein the trunk module includes a strap for attaching the brace to the body; and at least one first part of a locking mechanism; a forearm module pivotable relative to the trunk module, the forearm module further including a second part of a locking mechanism capable of engaging and disengaging with the at least one first part of the locking mechanism; and a posterior upper arm support attached to the trunk module in a fixed position; wherein in a first orientation the at least one first part of the locking mechanism is engaged with the second part of the locking mechanism; and wherein in a second orientation the at least one first part of the locking mechanism is disengaged from the second part of the locking mechanism.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application claims priority to European patent applicationnumber 15306005.8 filed Jun. 25, 2015 and entitled “Improvements in orrelating to upper extremity braces.” The subject matter of patentapplication number 15306005.8 is hereby incorporated by reference in itsentirety.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not Applicable.

INCORPORATION BY REFERENCE OF MATERIAL SUBMITTED ON A COMPACT DISC

Not Applicable.

BACKGROUND

It is known to use a brace or splint to support a joint which hasundergone either an operation, been injured or is the subject of a longexisting medical condition. Different joints require different braces tosupport the joint, each being adapted accordingly. Braces can be used onboth the upper and lower extremities of the human body. One joint whichis particularly susceptible to injury and problems, and which oftenrequires surgery, is the shoulder. The shoulder is a complex joint withmany bones, tendons, muscles and the like. After injury or surgery, itis often necessary to immobilize the shoulder to avoid or restrictmovement and in turn aid the healing process.

Current existing braces for shoulders are cumbersome and give rise to anumber of problems both from a practical point of view and a medicalpoint of view. Typically shoulder braces are adapted to maintain theshoulder in a fixed position by strapping the arm in some way to thebody by means of straps, belts, suspenders, and the like. The positionof the arm relative to the body will depend upon the type of problem thepatient has. In some cases the forearm will be across the body, in othercases the forearm will be extended upwards and in other situations theforearm may extend horizontally from the body in line with the shoulder.Typical types of existing braces are shown in FIG. 1.

Some of the problems associated with the existing braces are discussedbelow. One problem with existing braces is that they are verycomplicated to use. It is very difficult if not impossible for thepatient to put on or remove the brace alone and help is generallyrequired to position the brace correctly.

It is also difficult to find a brace that fits all patients. Thisgenerally means there are different braces for different sized people.As a result it is necessary to have a number of different sized braces,this adds to the costs of the design and manufacture and means that thehospital or doctor's surgeries need to stock many braces of differentsizes.

Most of the existing braces completely immobilize the upper limb (asrequired) and the forearm tends to be confined within a portion of thebrace, which completely captures the forearm by means of acircumferential tube with straps. The elbow joint is typicallymaintained at about 90° and the forearm is restricted and practicallyunable to move. This can lead to a number of problems such as elbowstiffness, stagnation of edema and hematoma, swelling, paresthesia, veinthrombosis and the like. In addition, compartment syndrome in theforearm may occur. The fact that the upper limb is rigidly held in afixed position may also be detrimental to future joint function and mayresult in tissue atrophy. In most existing braces there are straps whichgo round the neck and the back the patient and can cause chafing of theskin and in some cases the sensation of strangulation.

If the patient were to attempt to extend the elbow and straighten thearm, any such movement would typically bring about a forward projectionof the shoulder. This can provide a source of pain by tensioning thesoft tissue and disturbing any bone fracture fragments being repaired.If this occurs in the early stages of recuperation, when lying down, thereattachment sutures can be compromised and the tendons and ligamentsmay become detached. This is particularly the case for surgery to repairthe rotator cuff, Bankart lesions or osteosynthesis. It should be notedthat the current braces do not provide the facility for the patients' tomove the elbow, but trying to do so inadvertently can result in theproblem identified above.

Due to the nature of existing braces, patients often find sleepingdifficult and uncomfortable. With the elbow at 90° flexion in mostsituations, the hand extends upwards when the patient is sleeping. Thiscan lead to numbness and lack of blood flow in the hands and lower arm.In addition, the elbow and wrist can become stiff due to lack ofmovement.

Most existing shoulder braces immobilize the shoulder's internalrotation, which may causes harmful consequences to the tendons andligaments and bones as highlighted below.

For healing tendons of the rotator cuff, the arm position adopted usingexisting shoulder braces typically does not match the natural restposition or the muscular balance and tendon positions of the shoulder.This gives rise to tensioning of the external rotator muscles andshrinkage of the internal rotator muscles and the rotator interval.

For healing the lesions of the labrum and glenohumeral ligaments in thecase of anterior and posterior shoulder instability, immobilization ininternal rotation may cause medial scarring of the labrum, which is arecurrent source of anterior instability of the shoulder. Conversely,the neutral rotation or external rotation works in favor of closing theBankart separation and the healing of the labrum is in a good position.

For healing fractures of the proximal humerus, immobilization ofinternal rotation of the shoulder after a fracture of the proximalhumerus leads to consolidation in a faulty position: for instancemalunion in the internal rotation in diaphyseal fractures of thesurgical neck and tuberosity malunion in fractures having 3 or 4fragments can lead to posteromedial migration of the tochiter andanteromedial migration of the lesser tuberosity.

SUMMARY

A brace for supporting the forearm and for restricting movement of oneof more joint is provided. This Summary is provided to introduce aselection of disclosed concepts in a simplified form that are furtherdescribed below in the Detailed Description including the drawingsprovided. This Summary is not intended to identify key features oressential features of the claimed subject matter. Nor is this Summaryintended to be used to limit the claimed subject matter's scope.

An object of the present invention is to seek to solve at least someproblems presented above. In addition, it is an object of the presentinvention to enable the shoulder to be immobilized in a position ofneutral rotation of the shoulder with about 90° flexion of the elbow andalso to allow easy mobilization of the shoulder, elbow and wrist asrequired, to avoid stiffness and retraction of the muscles and tendons,which can become irreversible. In addition, the neutral rotation aidsrecovery during rehabilitation.

A further object of the present invention is to provide a brace whichallows the patient to sleep with their arm extended (in other words notat 90° flexion), without any detrimental mobilization of the shoulder.

In addition, it is an object of the present invention to provide a bracewhich can be easily put on and taken off by the patient withoutassistance from a third party.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this disclosure, illustrate various example embodiments. In thedrawings:

FIG. 1 is a drawing showing a number of existing braces, forming theprior art.

FIG. 2a is a schematic diagram showing a side view of a brace with theelbow at about 90° flexion, in accordance with an aspect of the presentinvention.

FIG. 2b is a schematic diagram showing a side view of a brace with theelbow extended, in accordance with an aspect of the present invention.

FIG. 3 is a schematic diagram of the elbow lock in an extended position,in accordance with an aspect of the present invention.

FIG. 4a is a more detailed schematic diagram of the elbow lock of FIG. 3with the lock at about 90° flexion, in accordance with an aspect of thepresent invention.

FIG. 4b is a more detailed schematic diagram of the elbow lock of FIG. 3with the lock open, in accordance with an aspect of the presentinvention

FIG. 5 is a schematic diagram of a rear view of the brace, in accordancewith an aspect of the present invention.

FIG. 6 is a schematic diagram of the front view the brace, in accordancewith an aspect of the present invention.

DETAILED DESCRIPTION

The following detailed description refers to the accompanying drawings.Wherever possible, the same reference numbers are used in the drawingsand the following description to refer to the same or similar elements.While embodiments may be described, modifications, adaptations, andother implementations are possible. For example, substitutions,additions, or modifications may be made to the elements illustrated inthe drawings, and the methods described herein may be modified bysubstituting, reordering, or adding stages to the disclosed methods.Accordingly, the following detailed description does not limit theinvention. Instead, the proper scope of the invention is defined by theappended claims.

According to one aspect of the present invention, there is provided abrace for supporting the forearm and for restricting movement of one ofmore joint, the brace comprising:—a trunk module attachable to a humanbody in the vicinity of the torso at the side of the body correspondingto the arm to be supported, wherein the trunk module includes a strapfor attaching the brace to the body; and at least one first part of alocking mechanism; —a forearm module pivotable relative to the trunkmodule and adapted to support the forearm in a plurality of positionsrelative to the upper arm, the forearm module further including at leastone second part of a locking mechanism capable of engaging anddisengaging with said first part of the locking mechanism; and —aposterior upper arm support attached to the brace in a fixed position toprevent movement of the upper arm and shoulder; wherein in a firstorientation the at least one first part of the locking mechanism isengaged with the at least one second part of the locking mechanism suchthat forearm module is capable of positioning the forearm at firstposition relative to the upper arm; and wherein in a second orientationthe at least one first part of the locking mechanism is disengaged fromthe at least one second part of the locking mechanism such that theforearm module is capable of pivoting relative to the trunk module toenable the forearm to be positioned at a second position relative to theupper arm.

Preferably the first and second part of the locking mechanism comprise ahook engageable with a notch.

In an embodiment the first position of the forearm relative to the upperarm is at an angle of about 90°.

Preferably the second position of the forearm relative to the upper armis at an angle between about 90° and about 180°.

Preferably the trunk module further comprises a cushion for supportingthe arm against body at a particular lateral displacement, based on thethickness of the cushion.

Preferably the trunk module further comprises an elasticated strap whichpasses round the body to hold the trunk module in the required position.

Preferably the elasticated strap includes a fixing for securing theelasticated strap.

Preferably the forearm module comprises a channel for supporting theforearm, wherein the channel includes an inner and outer edge and acurved-base portion.

Preferably the inner edge of the channel is higher than the outer edgeof the channel.

In an embodiment one of the first or second part of the lockingmechanism is located on the inner edge of the channel.

In an embodiment the trunk module includes connection plate on which oneof the first or second part of the locking mechanism is located.

In an embodiment a pivot pin is located between the connection plate andthe forearm module to allow the forearm module to pivot relative to thetrunk module.

Preferably more than one first and second parts of the locking mechanismcan enable the forearm to be secured in intermediate positions betweenabout 90° and about 180° on engagement of different first and secondparts.

Preferably the brace for allows movement of at least one of theshoulder, elbow, wrist or forearm.

According to a second aspect of the present invention there is provideda brace for supporting the forearm comprising a trunk module attachableto a human body in the vicinity of the torso at the side of the bodycorresponding to the arm to be supported and an arm support attached tothe trunk module for supporting the arm in a predetermined position;wherein the trunk module comprises a cushion for supporting the armagainst the body at a particular lateral displacement, based on thethickness of the cushion and a large elasticated strap which passesround the body to hold the trunk module in the required position.

According to a third aspect of the present invention there is provided amethod of using the brace of the first and second aspects to support anarm.

According to a third aspect of the present invention there is provided amethod of treatment using the brace of the first and second aspects totreat an arm.

Statements of invention to add once the claims are finalized.

In an embodiment, there is provided a brace restricting the movement ofthe shoulder and elbow joints with the following advantages:

-   -   a) A large belt or strap and a simple attachment system which        allows the patient to put on and remove the brace alone (without        the need of third party) keeping the patient autonomous and        independent;    -   b) A pivoting system located at the elbow joint, which allows        the patient to move the elbow joint in flexion-extension (when        needed) without moving the shoulder joint. This allows:        -   extension of the elbow when sleeping at night while keeping            the shoulder immobilized (in case of trauma or surgery of            the shoulder);        -   mobilization the elbow to avoid stiffness during the day (in            case of trauma or surgery of the elbow or of the shoulder);    -   c) A forearm module in the form of a half-tube, which leaves the        forearm free (without being entrapped in a circumferential bag),        to thereby allow:        -   reduction of any compression of the forearm;        -   the patient to remove the forearm from the forearm module to            carry out self-rehabilitation with pendulum exercises and            the like and then for the patient to be easily able to put            the forearm back in the half tube and to put it back;    -   d) A pommel, which keeps the hand in a relaxed and functional        position and allows the patient to squeeze a ball to improve        blood circulation in the arm.

The present invention solves the problems of the prior art by providinga brace with an articulated elbow lock which enables immobilization ofthe joint when required, whilst providing the flexibility of being ableto move the elbow in order to prevent stiffness and the other practicaland medical problems highlighted above. The articulated elbow lock canbe used, for example when the patient wishes to extend the arm so thatit is straight, for example when sleeping or when carrying outphysiotherapy exercises. The elbow can then be returned to 90° positionwhen required.

The articulated elbow lock can be used to position the lower arm indifferent positions at different times to allow the lower arm to changeposition, without moving the shoulder in any detrimental way. Thepresent invention also provides a brace which supports and positions thearm in the correct position without capturing the arm in a closablecircumferential tube. In addition, the arrangement even allows thepatient to be able to use their hand.

The open nature of the various elements of the new brace allows thepatient to be less constrained but still supported as required. Thepatient can take off and put on the brace without help from a thirdparty. The ability of the patient to ensure personal hygiene is alsoimproved by the nature of brace according to the present invention. Inaddition, the risks of sweating and the resulting potential fungalinventions can be prevented.

Reference will now be made by way of example, to the accompanyingdrawings.

Referring to FIG. 2a , a schematic representation of a brace 200 isshown, in accordance with an embodiment of the present invention. InFIG. 2a the brace is shown with the elbow at about 90° flexion and inFIG. 2b the brace is shown with the elbow extended. At 90° flexion ofthe elbow, the forearm is held in a position of about 90° relative tothe upper arm. With the elbow in an extended position the forearm is atan angle greater than about 90° and less than about 180° relative to theupper arm. The reference numbers for both FIG. 2a and FIG. 2b are thesame. The description below relates to the position of the brace withthe elbow at 90° flexion. It will be appreciated that the descriptionapplies equally to FIG. 2 b.

The brace 200 includes a trunk module 202 and a forearm module 204. Thetrunk module and the forearm module are connected together by aconnection plate shown generally at 206, which will be described ingreater detail below.

The connection plate comprises an articulation allowing for freedom ofmovement in the sagittal plane. This enables flexion and extension ofthe elbow in a plane which passes from the anterior to the posterior ofthe body dividing the body into left and right half. The connectionplate further includes a hook 208 which can hold the elbow in the 90°flexion position when engaged with the forearm module.

The brace also includes a posterior upper arm support 210 which is fixedrelative to the brace on the trunk module by means of the connectionplate, such that there is no movement of the upper part of the arm orthe shoulder even when the lower part of the arm is extended. Theposterior upper arm support is not connected to the forearm module. Theposterior upper arm support is adapted to hold the upper arm in a fixedposition and may include an open support as shown in FIG. 2a or may beclosed by means of straps or other means. The posterior arm uppersupport may be made of a pliable material, such as aluminum or athermoplastic, to enable shaping of the posterior upper arm support tofit the patient. Cushioning or equivalent soft materials may beincorporated into the internal surface of the posterior upper armsupport for the comfort of the patient.

The trunk module comprises a cushion 212 and a fixing strap 214 (seeFIG. 3). The cushion is typically crescent shaped and is positionedaround the torso to the front and side of the patient. The cushion maybe of foam or any other appropriate material or may be inflatable. Thecushion may be of any thickness, depending on the amount of lateraldisplacement required for the arm relative to the body. Typically thismay be about 20° abduction. If a greater, for example 46° to 60° orsmaller abduction is required the cushion may be made bigger or smallerrespectively. The cushion is designed such that it does not extendposteriorly (i.e. on the dorsal part of the torso) in order to avoidspine curvature and discomfort when the patient is lying down. When seenfrom the front the lower part of the cushion extends slightly downwardon the hip so as to obtain a wide base which is comfortable when restingthe arm in the forearm module (see FIG. 6). Seen from the side the frontof the cushion is indented around the pubis to avoid contact with thelegs when sitting down. The fixing strap is a wide elastic strap whichwraps round the torso having hook-and-loop fittings to secure the strap.

The strap has a large width of between about 10 cm to 20 cm and isdesigned to be sufficiently wide to support the arm without the need ofadditional straps around the neck or any other attachments. This makesthe brace significantly more comfortable for the patient to wear. Thecombination of a cushion and a large width strap provides a morecomfortable brace, solving some of the discomfort issues of previouslyexisting braces. In an alternative embodiment the strap can be in theform of a large belt, with appropriate fastenings. The strap is anintegral part of the cushion and holds the whole brace in place. It maybe necessary for larger patients, to employ an additional support, forexample a shoulder strap, to help support the brace in position.

Both the cushion and fixing strap shown in the drawings can be adaptedin many ways to fulfill the same function, as such the description aboveis not intended to limit the form, shape or make up of the cushion andfixing strap. The combination of the cushion and fixing strap may beused in conjunction with the brace according to the present invention orindeed in with other braces, even where elbow movement is restricted.The unique combination of the cushion and fixing strap addresses theproblem of the patient being able to put the brace on by themselves.With the particular arrangement disclosed herein the patient can put onand take off the brace without help from other people. This gives muchgreater autonomy to the patient.

The forearm module includes a channel 216 for receiving the forearm. Thechannel is a thermoplastic molded or other malleable material andincludes padding where required. The inner edge of the channel 216 (theedge in contact with the cushion of the trunk module) is higher than theouter edge of the channel 220 in order to keep the shoulder in aposition of neutral rotation and to facilitate movement of the elbow aswill be described in greater detail below. The channel further includesa curved base portion 222 for supporting the arm. The channel includes astrap 224 which can be attached by hook-and-loop or any otherappropriate fixing. The strap extends from the inner edge to the outeredge of the channel to hold the forearm in place within the channel.

The forearm module further includes a removable and adjustable palmsupport 226 which can be adjusted in terms of length and inclination tocorrectly support the hand. The palm support may be fitted with paddingand/or a ball (not shown) which the patient can squeeze to exercise thefingers. The length and inclination of the palm support relative to thechannel can be adjusted according to the requirements of patient and canbe changed by the patient to alleviate any tingling or other symptoms inthe hand which cause discomfort to the patient. In an embodiment of thepresent invention, the palm support may be capable of being manipulatedby the hand in order to give the opportunity to exercise the fingerswithout the need for a separate ball.

Referring to FIG. 3, the connection plate 206 is attached to the cushionand is juxtaposed to the forearm module. The connection plate isattached to the trunk module by means of a flat hook-and-loop system ona flat reinforced posterior section shown in FIG. 5, reference 232. Theattachment of the cushion to the connecting plate can made by many othermeans, one such means being a magnetic system for example.

The forearm module 204 is fixed to the connection plate by means of thejoint axis 228 which plays a dual role namely securing the connectionplate to the front arm module and providing the joint axis of rotationfor the forearm module relative to the trunk module (this will bedescribed in more detail below).

In one embodiment the connection plate 206 and the forearm module 204are a single unit that is secured to the trunk module by thehook-and-loop or magnetic system 232. This allows positioning theassembly of the connection plate 206 and the forearm module 204according to each patient's arm length from the shoulder to the elbowand in turn ensures the location of the pivot point 228 is suitable foreach patient.

The pivot pin 228 (see FIGS. 4a and 4b ) is located in the region of theconnection plate 206 and provides the joint axis of rotation for theforearm module relative to the trunk module (this will be described inmore detail below).

The connection plate includes a hook 208 on the outer surface thereof,towards the front of the trunk module. The hook extends outwardly fromthe connection plate towards the forearm module and then upwards. Thehook generally includes curved surfaces so that the hook cannot causeinjure to the forearm. On the forearm module the inner edge 216 (thesurface closest to the cushion) includes a notch 230 towards the frontend thereof, which is adapted to receive the hook 208. The notch ispositioned on the inner edge of the forearm channel in such a positionthat when the elbow is at about 90° flexion the notch is aligned withthe hook and can engage with the hook. The hook may be made of theplastics material or any other appropriate material that can engage withthe notch on the inner surface of the forearm channel.

There may be several hooks in different positions on the connectionplate, so that the forearm can be extended by different degrees.Alternatively there may be several notches on the inner edge of theforearm module which engage with a single hook to enable the samevariation in extension of the forearm.

It should be noted that the hook and notch may be located respectivelyon the inner edge of the forearm module and on the connection plate. Inother words on the opposite surfaces to that described above. In thisarrangement the hook would be pointing downwards rather than upwards toenable engagement with the corresponding notch.

It will be appreciated that different forms of locking device may beused instead of the notch and hook arrangement described herein.

In normal use of the brace, the hook is fixed into the notch to keep theelbow in the preferred 90° flexion position. However, when the patientwishes to extend their arm they simply need to disengage the hook fromthe notch to allow the forearm to extend. As the posterior upper armsupport is not connected to the forearm module the upper arm does notmove when the forearm is extended this ensures that the shoulder jointis maintained in its required position for healing.

In one embodiment, the hook and notch can the disengaged by slightcontraction of the bicep muscle which causes the forearm channel toraise slightly relative to the cushion. This slight movements candisengage the hook from the notch and enable the patient to subsequentlyextend their arm to another position other than 90° flexion about thepivot point provided by pin 228. To return the arm to the 90° flexionposition the patient need only lift their forearm with the other hand tore-engage the hook in the notch. The rigidity of the pivot pointsubstantially prevents any movement of the forearm module in otherdirections than that intended by the pivot point itself.

FIGS. 4a and 4b show the brace in the position of the elbow at about 90°flexion and with the elbow extended respectively. In both diagrams theaxis of rotation of the brace is shown. The axis of rotation forms ahinge between the link plate and forearm module at the rear end of theforearm channel. The hinge comprises a simple metallic pin 228positioned facing the elbow joint which holds the link plate and theforearm module together at the rear and enables the forearm module torotate relative to the pin when the hook and notch are disengaged. Thesefigures also enable clear visibility of the hook and notch in both theirengaged and disengaged positions.

FIG. 5 and FIG. 6 show respectively the rear and front views of thebrace, in accordance with the present invention. In FIG. 5a thehook-and-loop support 232 is shown which is used to rigidly fix theforearm module to the trunk module. The posterior arm support is alsorigidly connected to the connection plate to ensure the correct positionof the upper arm in the brace. It should be noted the upper arm supportcan be fixed to other parts of brace as long as the upper arm issupported rigidly and is unable to move. An example of the shape of thecushion can be also seen in FIGS. 5 and 6.

The above described brace combines the required immobilization ofvarious joints, such as the shoulder, elbow, and wrist. These joints aremaintained in a rest position for a majority of the time butmobilization of certain joints is simple and autonomous therebypreventing stiffness and muscle and tendon problems.

The brace in accordance with the present invention provides a number ofclear advantages over existing braces. The shoulder is immobilized in aposition of neutral rotation and about 20° of abduction whichcorresponds to the rest position and the muscle tendon balance whichgives the minimum tension to the cuff tendons and muscles. In the caseof fractures of the proximal humerus the neutral position of rotation ofthe shoulder prevents malunion of the diaphysis and malunion of thetuberosity. In the case of anterior shoulder dislocation orreintegration of the anterior labrum, neutral rotation promotes healingin a good position on the anterior edge of the glenoid. In the case ofrepair of tendons in the rotator cuff, there is a perfect equilibriumbetween internal and external rotator cuff muscles, which is required tooptimize the healing of the shoulder.

As the brace allows for elbow extension whilst the patient is eitherlying or standing muscle tendon retraction of the flexor muscles of theelbow is avoided thereby avoiding stiffness in the joint. The ability toextend the elbow a number of times during the day allows for thedispersion of any hematoma or post fracture or postsurgical edema. Whenthe patient is lying down, the ability to extend the elbow means thatsleeping is easier and the hand does not undergo unpleasant symptomssuch as cooling, numbness and tingling.

When the patient is lying down elbow extension does not cause anymovement of the shoulder, which protects osteosynthesis, re-insertionsand tendon or ligament sutures. In addition, there is no pain generatedby putting the soft tissue and bone fracture fragments under tension.

Mobilization of the elbow whilst the shoulder is not removed from thebrace is possible. This allows for alternative postures and maximumoutput amplitude gain obtained after arthrolysis of the elbow. Theability to carry out a pendulum movement with the shoulder is notinhibited by the brace.

As the brace only uses a simple waist belt to hold the arm in positionthe patient can easily attach the brace autonomously without help from athird party. In addition, there are no complicated straps which cancause chafing and irritation and which are complex to put on even withhelp.

The brace includes an open channel for the forearm which means thatthere is support but not compression of the elbow and forearm. This hasa number of advantages in terms of preventing unpleasant symptoms suchas coldness in the forearm and hand, nerve tingling, and numbness.

The brace can be used in the treatment of a number of differentconditions affecting the shoulder, elbow and/or wrist. These include:

-   -   a) Damage and/or reinsertion of tendons and soft tissue to the        bone, for example rotator cuff or capsule in the shoulder;        medial, lateral and cruciate ligaments in the elbow; and        ligaments in the wrist and hand. It should be noted that for use        with the elbow and or wrist the brace would typically be used to        immobilize the joint for a first period of time, for example 2        to 3 weeks. Thereafter gradual reintroduction of movement of the        elbow or wrist could be undertaken to aid the healing process        and prevent the joint becoming unduly stiff.    -   b) Orthopedic treatment of fractures of the shoulder, elbow and        wrist and also fractures of the humerus and/or forearm.    -   c) Surgical treatment of fractures of the shoulder, elbow,        wrist, humerus and forearm; including the implantation of        plates, pins nails, anatomical implants, prostheses et cetera.    -   d) Treatment of neurological pathologies such as monoplegia,        hemiplegia or myopathy as well as the effects of paralysis of        the brachial plexus.

In shoulder surgery the brace can be used post-operative preferably forany procedure, including but not limited to the following:

-   -   a) repair of the labral lesions;    -   b) SLAP (superior labral tear from anterior to posterior)        lesions;    -   c) previous or subsequent dislocations;    -   d) repair of the rotator tendons;    -   e) total shoulder prosthesis;    -   f) fractures of the proximal humerus.

It will be appreciated that the above described brace may be adapted innumerous ways whilst still being within the scope of the presentinvention. Each element of the brace may be adapted, made of differentmaterials, or orientated relative to one another in a different manner.All the various alternatives are intended to be included within thescope of the present invention.

What is claimed is:
 1. A brace for supporting the forearm and forrestricting movement of one of more joints, the brace comprising: atrunk module attachable to a human body in a vicinity of a torso at aside of the body corresponding to an arm to be supported, wherein thetrunk module includes a strap for attaching the brace to the body; and afirst part of a locking mechanism; a forearm module pivotable relativeto the trunk module and adapted to support the forearm in a plurality ofpositions relative to an upper arm, the forearm module further includinga second part of a locking mechanism capable of engaging and disengagingwith said first part of the locking mechanism; a posterior upper armsupport attached to the brace in a fixed position to prevent movement ofthe upper arm and shoulder; wherein in a first orientation the firstpart of the locking mechanism is engaged with the second part of thelocking mechanism such that the forearm module is capable of positioningthe forearm at a first position relative to the upper arm; and whereinin a second orientation the first part of the locking mechanism isdisengaged from the second part of the locking mechanism such that theforearm module is capable of pivoting relative to the trunk module toenable the forearm to be positioned at a second position relative to theupper arm; wherein the trunk module includes a connection plate on whichone of the first or second part of the locking mechanism is located; anda pivot joint pivotally connecting the connection plate and the forearmmodule to allow the forearm module to pivot relative to the trunkmodule.
 2. The brace according to claim 1, wherein the first and secondpart of the locking mechanism comprise a hook engageable with a notch.3. The brace according to claim 1, wherein the first position of theforearm relative to the upper arm is at an angle of about 90°.
 4. Thebrace according to claim 1, wherein the second position of the forearmrelative to the upper arm is at an angle between about 90° and about180°.
 5. The brace according to claim 1, wherein the trunk modulefurther comprises a cushion for supporting the arm against the body at aparticular lateral displacement, based on a thickness of the cushion. 6.The brace according to claim 1, wherein the trunk module furthercomprises an elasticated strap which passes around the body to hold thetrunk module in the required position.
 7. The brace according to claim6, wherein the elasticated strap includes a fixing for securing theelasticated strap.
 8. The brace according to claim 1, wherein theforearm module comprises a channel for supporting the forearm, whereinthe channel includes an inner and outer edge and a curved-base portion.9. The brace according to claim 8, wherein the inner edge of the channelis higher than the outer edge of the channel.
 10. The brace according toclaim 8, wherein one of the first or second part of the lockingmechanism is located on the inner edge of the channel.
 11. The braceaccording to claim 1, wherein said pivot joint includes a pivot pin. 12.The brace according to claim 1, further comprising more than one firstand second parts of the locking mechanism to enable the forearm to besecured in intermediate positions between about 90° and about 180° onengagement of different first and second parts.
 13. The brace accordingto claim 1 for allowing movement of at least one of the shoulder, elbow,wrist or forearm.